Zhu Wen-Jing, Yu Qiang, Wang Ping-Zhong, Shi Hui-Min
Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China. E-mail:
Shanghai Kou Qiang Yi Xue. 2017 Aug;26(4):441-446.
The objective of the present study was to evaluate the potential application value of diffusion-weighted magnetic resonance imaging (DW-MRI) to differentiate solid benign from malignant tumors affecting the base of tongue and glossopharynx.
Sixty-one patients who presented with solid tumors affecting the base of tongue and glossopharynx underwent conventional MRI and DW-MRI before pathologic verification. Based on pathologic findings, the tumors were classified into 4 groups: Group 1, solid benign tumor (n=10); Group 2, epithelial carcinoma (n=35); Group 3: non- epithelial malignant tumor (n=16); and Group 4: malignant tumor (n=51, a combination of Group 2 and 3). The mean apparent diffusion coefficients (ADCs) were computed from DW-MRI scans obtained with b factors of 0 and 1000 s/mm2. SAS 9.1 software package was used for Wilcoxon test.
The mean ADCs were significantly different (P<0.05) between group 1 and the other 3 groups, and between group 2 and group 3, respectively. Among all kinds of pathological types of lesions, non-Hodgkin lymphoma had a lowest mean ADC value, and schwannoma had a highest mean ADC value. In addition, the mean ADCs among epithelial carcinoma subtypes were not significantly different(P>0.05).
DW-MRI has differential diagnostic value of solid tumors affecting the base of tongue and glossopharynx, especially in distinguishing between benign solid tumors and malignant tumors, and between epithelial carcinomas and non-epithelial malignant tumors.
本研究的目的是评估扩散加权磁共振成像(DW-MRI)在鉴别影响舌根和舌咽的实性良性肿瘤与恶性肿瘤方面的潜在应用价值。
61例患有影响舌根和舌咽的实性肿瘤的患者在病理证实前接受了常规MRI和DW-MRI检查。根据病理结果,将肿瘤分为4组:第1组,实性良性肿瘤(n = 10);第2组,上皮癌(n = 35);第3组:非上皮性恶性肿瘤(n = 16);第4组:恶性肿瘤(n = 51,第2组和第3组的组合)。平均表观扩散系数(ADC)由b因子为0和1000 s/mm2的DW-MRI扫描计算得出。使用SAS 9.1软件包进行Wilcoxon检验。
第1组与其他3组之间以及第2组和第3组之间的平均ADC存在显著差异(P<0.05)。在所有类型的病变病理类型中,非霍奇金淋巴瘤的平均ADC值最低,神经鞘瘤的平均ADC值最高。此外,上皮癌亚型之间的平均ADC无显著差异(P>0.05)。
DW-MRI对影响舌根和舌咽的实性肿瘤具有鉴别诊断价值,尤其是在区分良性实性肿瘤与恶性肿瘤以及上皮癌与非上皮性恶性肿瘤方面。